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Masanori Sugiyama, Yutaka Suzuki, Tetsuya Nakazato, Masaaki Yokoyama, Masaharu Kogure, Nobutsugu Abe
BACKGROUND: Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non-dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze-out technique facilitating duct-to-mucosa anastomosis. We compared the perioperative outcomes of pancreatoduodenectomy with duct-to-mucosa pancreatojejunostomy between the novel and conventional procedures. METHODS: Our pancreatic holder has a cone-shaped tip with a slit...
August 8, 2016: World Journal of Surgery
Matthew T McMillan, Giuseppe Malleo, Claudio Bassi, Valentina Allegrini, Luca Casetti, Jeffrey A Drebin, Alessandro Esposito, Luca Landoni, Major K Lee, Alessandra Pulvirenti, Robert E Roses, Roberto Salvia, Charles M Vollmer
OBJECTIVE: This multicenter study sought to prospectively evaluate a drain management protocol for pancreatoduodenectomy (PD). BACKGROUND: Recent evidence suggests value for both selective drain placement and early drain removal for PD. Both strategies have been associated with reduced rates of clinically relevant pancreatic fistula (CR-POPF)-the most common and morbid complication after PD. METHODS: The protocol was applied to 260 consecutive PDs performed at two institutions over 17 months...
June 24, 2016: Annals of Surgery
A Papalampros, K Niehaus, D Moris, M Fard-Aghaie, G Stavrou, A-G Margonis, A Angelou, K Oldhafer
INTRODUCTION: Postoperative pancreatic fistula (POPF) is one of the most frequent and serious postoperative complications of pancreatoduodenectomy (PD). We sought to assess the impact of a novel pancreaticojejunostomy (PJ) on the rates of POPF and overall postoperative complications. METHODS: Between 01/2010 and 12/2013, a total of 248 consecutive patients who underwent PD with a modified PJ were identified from our database and retrospectively analyzed. POPF cases were divided into three categories (ISGPF-international study group-guidelines): biochemical fistula without clinical sequelae (grade A), fistula requiring any therapeutic intervention (grade B), and fistula with severe clinical sequelae (grade C)...
May 30, 2016: Journal of Visceral Surgery
A Giardino, G Spolverato, P Regi, I Frigerio, F Scopelliti, R Girelli, Z Pawlik, P Pederzoli, C Bassi, G Butturini
BACKGROUND: The association between postoperative inflammatory markers and risk of complications after pancreaticoduodenectomy (PD) is controversial. We sought to assess the diagnostic value of perioperative C-reactive protein (CRP) and procalcitonin (PCT) levels in the early identification of patients at risk for complications after PD. METHODS: In 2014, 84 patients undergoing elective PD were enrolled in a prospective database. Clinicopathological characteristics, CRP and PCT, as well as short-term outcomes, such as complications and pancreatic fistula, were analyzed...
August 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Marta Sandini, Giuseppe Malleo, Luca Gianotti
BACKGROUND/AIM: Different scoring systems to predict the occurrence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy have been described, but the considered risk factors often suffer subjective scaling. The aim of this review is to evaluate and compare all published risk metrics predictive of POPF. METHODS: All existing scores were retrieved by literature web search. Inclusion criteria were ISGPF classification of POPF and the development of a risk score metric...
2016: Digestive Surgery
Wooil Kwon, Jin-Young Jang, Jung Hoon Kim, Ye Rim Chang, Woohyun Jung, Mee Joo Kang, Sun-Whe Kim
BACKGROUND: Whether splenectomy is adverse or spleen preservation offers significant advantages in distal pancreatic resection is unclear. The aim was to compare the early/late clinical results and the functional outcomes in terms of quality of life (QoL) and nutrition between conventional laparoscopic distal pancreatectomy (LDP) and laparoscopic spleen-preserving distal pancreatectomy (LSPDP). STUDY DESIGN: Clinical data and computed tomography findings of 111 laparoscopic distal resections (79 LDPs and 32 LSPDPs) between 1999 and 2012 were retrospectively reviewed...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chi-Hua Fang, Qing-Shan Chen, Jian Yang, Fei Xiang, Zhao-Shan Fang, Wen Zhu
BACKGROUND: A majority of factors associated with the occurrence of clinical relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) can only be identified intra- or postoperatively. There are no reports for assessing the morphological features of pancreatic stump and analyzing its influence on CR-POPF risk after PD preoperatively. METHOD: A total of 90 patients underwent PD between April 2012 and May 2014 in our hospital were included...
June 2016: World Journal of Surgery
A G Kriger, S V Berelavichus, D S Gorin, A R Kaldarov, N A Karel'skaya, E A Akhtanin
AIM: To compare the results of robot-assisted and conventional techniques of pancreatoduodenectomy. MATERIAL AND METHODS: It was performed the retrospective investigation of results of robot-assisted and conventional pylorus-preserving pancreatoduodenectomy in 7 and 7 patients respectively. RESULTS: Duration of robot-assisted and conventional surgery was 460.71±119.77 and 288.57±62.2 minutes, volume of blood loss--414.28±285.36 and 400±163...
2015: Khirurgiia
Hanbaro Kim, Ki Byung Song, Dae Wook Hwang, Jae Hoon Lee, Sang Hyun Shin, Eun Sung Jun, Seong-Ryong Kim, Bong Jun Kwak, Tae Gu Kim, Kwang-Min Park, Young-Joo Lee, Song Cheol Kim
BACKGROUND: Preservation of the spleen in distal pancreatectomy has recently attracted considerable attention. Our current study aimed in the first instance to define the safety of lap-WT in relation to the capacity of this technique to achieve preservation of the spleen and secondly to investigate the effectiveness of a planned lap-WT procedure or early conversion to lap-WT in selected patients with a large tumor attached to the splenic vessels. METHODS: Among 1056 patients who underwent a laparoscopic distal pancreatectomy between January 2005 and December 2014 at our hospital, 122 (24...
September 2016: Surgical Endoscopy
M Abu Hilal, J R C Richardson, T de Rooij, E Dimovska, H Al-Saati, M G Besselink
BACKGROUND: Laparoscopic left pancreatectomy has been well described for benign pancreatic lesions, but its role in pancreatic adenocarcinoma remains open to debate. We report our results adopting a laparoscopic technique that obeys established oncologic principles of open distal pancreatosplenectomy. METHODS: This is a post hoc analysis of a prospectively kept database of 135 consecutive patients undergoing laparoscopic left pancreatectomy, performed across two sites in the UK and the Netherlands (07/2007-07/2015 Southampton and 10/2013-07/2015 Amsterdam)...
September 2016: Surgical Endoscopy
Abigail E Vallance, Alastair L Young, Christian Macutkiewicz, Keith J Roberts, Andrew M Smith
BACKGROUND: A post-operative pancreatic fistula (POPF) is a major cause of morbidity and mortality after a pancreaticoduodenectomy (PD). This systematic review aimed to identify all scoring systems to predict POPF after a PD, consider their clinical applicability and assess the study quality. METHOD: An electronic search was performed of Medline (1946-2014) and EMBASE (1996-2014) databases. Results were screened according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and quality assessed according to the QUIPS (quality in prognostic studies) tool...
November 2015: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Sung-Jin Park, Hyung-Il Seo, Soo-Hee Go, Sung-Pil Yun, Ji-Yeon Lee
BACKGROUNDS/AIMS: The objective of this study was to evaluate the relationship between initial personal experiences with distal pancreatectomy and perioperative risk factors, outcomes, and management of pancreatic fistulas. METHODS: Between May, 2007 and May, 2010, a total of 28 patients who had undergone elective distal pancreatectomy were evaluated for this study. Perioperative factors and the occurrence of pancreatic fistula were analyzed on the basis of International Study Group of Pancreatic Fistula (ISGPF) criteria...
November 2011: Korean Journal of Hepato-biliary-pancreatic Surgery
Hirofumi Akita, Hidenori Takahashi, Kunihito Gotoh, Shogo Kobayashi, Keijiro Sugimura, Norikatsu Miyoshi, Masaaki Motoori, Shingo Noura, Yoshiyuki Fujiwara, Masayuki Oue, Masahiko Yano, Masato Sakon, Osamu Ishikawa
PURPOSE: Pancreatic fistula (PF) remains an obstacle to safe distal pancreatectomy (DP). A thick pancreatic parenchyma is a major risk factor for PF. In this paper, we elucidate the feasibility of the new closure method using soft coagulation and polyglycolic acid felt with fibrin glue. METHODS: In 2009-2013, 96 patients underwent DP with a novel closure method for pancreatic stump that utilized soft coagulation and polyglycolic acid felt with fibrin glue. We evaluated amylase levels in drainage fluid on postoperative days (POD) 1 and 3 and the incidence of postoperative PF according to International Study Group of Pancreatic Fistula (ISGPF) definitions...
October 2015: Langenbeck's Archives of Surgery
Matthew T McMillan, Charles M Vollmer, Horacio J Asbun, Chad G Ball, Claudio Bassi, Joal D Beane, Adam C Berger, Mark Bloomston, Mark P Callery, John D Christein, Elijah Dixon, Jeffrey A Drebin, Carlos Fernandez-Del Castillo, William E Fisher, Zhi Ven Fong, Ericka Haverick, Michael G House, Steven J Hughes, Tara S Kent, John W Kunstman, Giuseppe Malleo, Amy L McElhany, Ronald R Salem, Kevin Soares, Michael H Sprys, Vicente Valero, Ammara A Watkins, Christopher L Wolfgang, Stephen W Behrman
INTRODUCTION: International Study Group of Pancreatic Fistula (ISGPF) grade C postoperative pancreatic fistulas (POPF) are the greatest contributor to major morbidity and mortality following pancreatoduodenectomy (PD); however, their infrequent occurrence has hindered deeper analysis. This study sought to develop a predictive algorithm, which could facilitate effective management of this challenging complication. METHODS: Data were accrued from 4301 PDs worldwide...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
In Geol Ho, Jae Keun Kim, Ho Kyoung Hwang, Jae Young Kim, Joon Seong Park, Dong Sup Yoon
BACKGROUNDS/AIMS: Few reports have validated the clinical postoperative pancreatic fistula (PF) after distal pancreatectomy. The study intended to validate the predictability for clinical PF of drain amylase and lipase and to find out more appropriate postoperative day (POD) for diagnostic criterion of PF. METHODS: A total of 154 patients underwent distal pancreatectomy. We used the clinical database registry system of the Gangnam Severance Hospital and Severance Hospital, Yonsei University Health System for these analyses...
August 2014: Korean Journal of Hepato-biliary-pancreatic Surgery
Jin Min Kim, Jung Bum Hong, Woo Young Shin, Yun-Mee Choe, Gun Young Lee, Seung Ik Ahn
BACKGROUNDS/AIMS: The post-operative complications and clinical course of pancreaticoduodenectomy (PD) largely depend on the pancreaticojejunostomy (PJ). Several methods of PJ are in clinical use. We analyzed the early results of binding pancreaticojejunostomy (BPJ), a technique reported by SY Peng. METHODS: We retrospectively reviewed the clinical results of patients who received BPJ in Inha University Hospital from 2006 to 2011. 21 BPJs were performed with Peng's method...
February 2014: Korean Journal of Hepato-biliary-pancreatic Surgery
Jee Ye Kim, Joon Seong Park, Jae Keun Kim, Dong Sup Yoon
BACKGROUNDS/AIMS: With recent advances in pancreatic surgery, pancreaticoduodenectomy (PD) has become increasingly safe. However, pancreatic leakage is still one of the leading postoperative complications. An accurate prediction model for pancreatic leakage after PD can be helpful for pancreas surgeons. The aim of this study was to provide a new model that was simple and useful with high accuracy for predicting pancreatic leakage after PD. METHODS: To predict the occurrence of pancreatic leakage, several factors were selected using bivariate analysis and univariate logistic regression analysis...
November 2013: Korean Journal of Hepato-biliary-pancreatic Surgery
Patricio M Polanco, Mazen S Zenati, Melissa E Hogg, Murtaza Shakir, Brian A Boone, David L Bartlett, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Proponents of the robotic platform site its potential advantages in complex reconstructions such as the pancreaticojejunal anastomosis; however, the incidence and risk factors for postoperative pancreatic fistula (POPF) after robotic pancreaticoduodenectomy (RPD) have not been characterized. OBJECTIVE: To identify independent risk factors for POPF after RPD. METHODS: A prospectively maintained database of patients that underwent RPD (2008-2013) with a standardized pancreaticojejunostomy was analyzed...
April 2016: Surgical Endoscopy
Ji-Ye Chen, Jian Feng, Xian-Qiang Wang, Shou-Wang Cai, Jia-Hong Dong, Yong-Liang Chen
AIM: To establish a scoring system to predict clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD). METHODS: The clinical records of 921 consecutive patients who underwent PD between 2008 and 2013 were reviewed retrospectively. Postoperative pancreatic fistula (POPF) was defined and classified by the international study group of pancreatic fistula (ISGPF). We used a logistic regression model to determine the independent risk factors of CR-POPF and developed a scoring system based on the regression coefficient of the logistic regression model...
May 21, 2015: World Journal of Gastroenterology: WJG
Tatsuya Oda, Shinji Hashimoto, Ryoichi Miyamoto, Osamu Shimomura, Kiyoshi Fukunaga, Keisuke Kohno, Yukio Ohshiro, Yoshimasa Akashi, Tsuyoshi Enomoto, Nobuhiro Ohkohchi
BACKGROUND: Among the types of pancreatic anastomosis used after pancreatoduodenectomy (PD), Blumgart type reconstruction has rapidly been distributed for its theoretical reasonableness, including secure tight adaptation of jejunal wall and pancreatic parenchyma without cause of parenchymal laceration. The clinical appropriateness of our modified Blumgart method was demonstrated by comparing to that of Kakita method. METHODS: Retrospective analysis of 156 patients underwent elective open PD, reconstructed former 78 patients with the Kakita method, utilizing a full-thickness penetrating suture for tight stump adhesion...
August 2015: World Journal of Surgery
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